Healthcare Provider Details

I. General information

NPI: 1992921811
Provider Name (Legal Business Name): SELIM UDDIN SHEIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2312 WHITEHORSE MERCERVILLE RD SUITE 100
HAMILTON NJ
08619-1953
US

IV. Provider business mailing address

2312 WHITEHORSE MERCERVILLE RD SUITE 100
HAMILTON NJ
08619-1953
US

V. Phone/Fax

Practice location:
  • Phone: 609-586-6244
  • Fax: 609-586-6221
Mailing address:
  • Phone: 609-586-6244
  • Fax: 609-586-6221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number25MA06108000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA06108000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: